Workout adaptation for short and long-term

So You Have an Injury

Are you afraid to workout when you have an injury? Maybe it's time for a new strategy.

“I can’t workout right now because I just hurt my _______.”

I’ve heard it thousands of times. Shoot, I’ve said it myself! Maybe it happened just when you were starting a new fitness habit or sport. Perhaps you’ve been ignoring a twinge for awhile, and when you woke up yesterday you could no longer raise your arms to wash your hair. Or you could have been blithely going about your day when a curb tripped you and now your knee is screaming.

We’ve probably all been there, deflated that we have to take time away from our workouts, and worried about what’s going to happen. We end up shrugging and accepting the inevitable–that we are just going to have to wait it out. Surely we’ll get it back at some point, right?

There have been some really interesting studies recently that look at the effects of short-term periods of inactivity—even as short as a few days. Alarmingly, the results are far more serious than I imagined, and what’s worse is that it appears that the negative effects don’t go away even several weeks after returning to activity.

Here are some of the consequences:

  • Impaired glucose tolerance (increased risk of developing diabetes and cardiovascular disease, along with more difficulty losing weight)
  • Lower resting metabolic rate (major factor in weight gain)
  • Markedly decreased vascular and endothelial function: I know! This one really excites me too!! Let’s unpack it.

Your blood vessels are pretty cool. They are not just little tubes carrying blood around your body, although they certainly do a great job of that under normal circumstances. You may remember that your arteries carry oxygenated blood away from your heart while your veins carry deoxygenated blood back to your heart. The endothelial layer is the innermost part of that blood vessel.

One of the primary jobs of the endothelium is to sense flow and adjust the diameter and thickness of the blood vessel wall in response to moderate blood flow and pressure. For example, when your working muscles start needing more oxygen and waste removal, blood flow increases, and the endothelium releases nitric oxide (NO) to dilate blood vessels to allow more blood through more rapidly. Then, working with the surrounding tissues, this starts the process of angiogenesis, the growth of new capillaries and blood vessels. And I’ll tell you–that is something that deserves a little celebration, because when it comes to blood vessels: we like them, we love them, we want some more of them!

Here’s why it matters to you:

Endothelial and vascular function is directly related to blood pressure and cardiovascular disease. And from a fitness perspective, compromise here means that your body becomes less efficient at delivering oxygen to your working muscles and removing waste, like the lactic acid which brings that burning sensation.

The point of all this is to say: if you go sedentary, even for just a few days, your body starts sliding downhill fast, affecting your metabolism, your overall fitness level and ability to workout, and increasing your health risks. And that dysfunction does not resolve even weeks after you resume your activity.

Geez–aren’t I the bearer of good news today?!?

But actually, if you’ve stuck with me this far, I want to give you hope:

You don’t have to stop working out. You shouldn’t.

Instead of quitting activity, first, understand that YES, you need to listen to your body. If doing “X” hurts, don’t do “X”. Also, NO, you should not ignore your doctor’s advice if you’re recovering from surgery or something else. I may be the only slow one in the room, but I once had the idea that post-op/doctor’s instructions were for my comfort, and I could return to activity as soon as I was tough enough to handle it. As it turns out, those timelines are actually based on physiological healing processes—the time it takes for your body to repair itself. Ignoring these could not only prolong your healing, but also cause further damage. So yeah, follow those instructions.

What I’m suggesting to you is that you workout around that injury. Or workout within the bounds of that illness. Train like you really are 57 and not 18—not that you can’t get into even BETTER shape than you were at 18, but your body responds differently. So how do we do that?

Here are some basic principles that should help:

  1. Protect the injured area and go slowly at first: Remember that instinctive movement patterns don’t stop just because you’re hurt. Hold on to a sturdy object so you don’t fall on that broken ankle. Wear your shoulder sling so you’re not tensing up or grabbing something, etc.
  2. Do strength training for every other part of the body: everything that does not affect the injured area. If, instead of injury, you’re dealing with illness or a long period of not working out, remember that strength training for you may not mean benching 250 lbs or doing power cleans. It may mean repeating some of your daily activities as you can tolerate—like standing up and sitting back down in a chair 5 or 10 times before you walk away or start the movie.
  3. Get the blood flowing. It doesn’t have to be intense. Go for a walk with the dog. Try some toe-touches. My sister dealt with painful lymphedema issues, and I used to stand in front of her and wave at her feet, and she would respond by waving her toes back. Even that helps!

I hope that these ideas may help get you started and, even more importantly, have you reconsidering your plan to spend those weeks on sedentary row. If you can find a trainer or physical therapist who knows how to adapt your program around your concerns, go work with them. Or schedule a consultation with me to develop a plan for your specific needs. This is definitely a time when having a guide could make all the difference!

If you have questions or feedback, I’d love to hear from you. Contact me at: [email protected] or leave a comment below.


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Workout adaptation for short and long-term

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Legal Disclaimer: Neither adaptiFit nor Andrea Ott are doctors. Guest posts may be from physicians who are doctors, but they are not Your doctor. Any opinions and advice shared is done to the best of our ability, but may not be appropriate for you. You should consult your actual doctor prior to beginning any fitness program, and especially when dealing with injury or illness. This is not a substitute for care by a qualified medical professional. If in doubt, don’t–as your mother probably told you. There is no guarantee that the advice and ideas presented on this site will make you skinny, pretty, happy, rich, or pain-free. And finally, one of the beauties of life and science is that new information can change our understanding of old ideas, so we reserve the right to change stance and  ideas on any topic. This will be an ever-evolving work, and there is no guarantee as to the accuracy, completeness, or reliability of the information contained herein. (But we will do our best!)